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for-profit corporation. In addition, Wife and Husband are partners in a for-profit

organization. For 16a, the answer would be yes. For 16b, the total number

relationships would be two. For 16c, the answer would be one business relationship

(the relationship between Wife and the other board member) and one for both (since

Husband and Wife have both a family relationship and business relationship).

17.

Select Yes or No depending on whether effective control of the organization rests

with a single or select few individuals. For example, is there a single individual or

small group of individuals to whom the board typically defers?

18.

a. Enter Yes or No depending on whether the organization has a written conflict of

interest policy.

b. If you responded Yes to question 18a, select Yes or No depending on whether the

conflict of interest policy addresses recusals. If you responded No to 18a, select Not

Applicable.

c. If you respond Yes to 18a, select Yes or No depending on whether the conflict of

interest policy requires annual written disclosures of conflicts of interest. If you

responded No to 18a, select Not Applicable.

d. Select Never adhered to, Sometimes adhered to, Always adhered to, or Not

Applicable depending on whether the organization’s conflict of interest policy was

adhered to. For example, did those with a conflict of interest on a particular matter

recuse themselves from the corresponding decision making process? If you

responded No to 18a, select Not Applicable. If no actual or potential conflicts of

interest were disclosed during the primary year under examination, select Not

Applicable.

19.

Select Yes or No depending on whether the organization has systems or procedures in

place intended to ensure that assets are used properly and consistently with the

organization’s mission.

20.

a. Select Never, Once per year, Twice per year, Quarterly, Once per month, Twice

per month, or Other depending on how often the organization provided board

members with written reports of the organization’s financial activities. The board

includes members with voting rights as well as those without voting rights.

b. Select Never, Once per year, Twice per year, Quarterly, Once per month, Twice

per month, or Other depending on how often the board discussed/considered reports

of the organization’s financial activities. For example, look at whether the

organization maintained complete, current, and accurate financial records, and

whether the board had and exercised the opportunity to discuss/consider those reports

and records. The board includes members with voting rights as well as those without

voting rights.

21.

Select Yes or No based on whether, prior to filing, the organization’s Form 990 was

reviewed by either the full board or a designated committee. Please note that the

question addresses a review of the Form 990 prior to filing, not merely receipt of the

Form 990 prior to filing. If the organization was not required to file a Form 990,

Form 990-EZ, or Form 990-N then select Not Applicable.

Governance Project Instructions - Guide Sheet For Completing The Project Check Sheet Page 3

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